先天性鼻泪管阻塞首次探通失败再治疗的临床分析

目的：分析我院就诊的28例首次泪道探通失败的先天性鼻泪管阻塞病例资料，总结再治疗策略。

方法：回顾性研究，选取2013-02-01/2017-12-31在我院就诊的591例患儿中的28例，均为首次泪道探通失败的先天性鼻泪管阻塞患儿(不包括外伤性和先天性泪道畸形)，收集病史、鼻腔情况、首次探通年龄，治疗前后情况等病例资料。

结果：患儿28例中，15例经再次泪道探通联合置管术，取管后已治愈； 10例患儿经下鼻甲处理后，再次泪道探通联合置管术，取管后已治愈； 2例患儿经常发作急性泪囊炎，在全身麻醉下行鼻内窥镜下鼻腔泪囊吻合术； 1例骨性鼻泪管狭窄和阻塞患儿，有溢泪不伴溢脓，建议定期随访，13岁后鼻窦发育完全后行鼻内窥镜下鼻腔泪囊吻合术。

结论：先天性鼻泪管阻塞首次泪道探通失败再治疗需采取个性化的阶梯治疗方案，合理治疗该疾病。

Congenital nasolacrimal duct obstruction agent through failure to treat clinical analysis for the first time

AIM: To report the data of 28 cases of congenital nasolacrimal duct obstruction who failed in the first probing of lacrimal passage in our hospital, summarize the strategy of retreatment.

METHODS: Retrospective study, selected 591 cases of children with 28 cases in our hospital from Feb. 1, 2013 to Dec. 31, 2017, all were for the first time of probing of lacrimal passage through failure of children with congenital nasolacrimal duct obstruction(not including traumatic and lacrimal duct abnormalities), collect the case history, the nasal situation, the age of the first time to probing of lacrimal passages, information such as case data before and after treatment.

RESULTS:In 28 cases, 15 cases with probing of lacrimal passage joint tube insertion second time, take the tube after cured, 10 cases treated with inferior turbinate, again with probing of lacrimal passage joint tube insertion, take the tube after cured, 2 cases of children with acute dacryocystitis often strikes, under general anesthesia with transnasal endoscopic dacryocystorhinostomy, 1 cases of children with bony nasolacrimal duct obstruction and strictures, with tears spill without overflow pus, pay a follow-up visit, sinus fully developed after the age of 13 under transnasal endoscopic dacryocystorhinostomy.

CONCLUSION: Congenital nasolacrimal duct obstruction of lacrimal duct exploration for the first time failed again take personalized ladder solution treatment, reasonable treatment of the disease.